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India's Real Death Toll May Be Many Times Higher Than The Official Count

AUDIE CORNISH, HOST:

This second wave of the coronavirus in India has also been breaking records for new infections, but scientists say the country's official numbers are almost certainly a vast undercount, as NPR's Lauren Frayer reports from Mumbai.

LAUREN FRAYER, BYLINE: Santosh Pandey's wife is the head of their village near the holy city of Varanasi in northern India, so he hears everything that goes on there. And what's going on now, he told NPR on a crackly phone line, is horrific.

SANTOSH PANDEY: (Non-English language spoken).

FRAYER: Fifty of their neighbors have died in the past two weeks, he says. Many of them have died at home with fevers, unable to breathe. Their bodies get cremated on the banks of the Ganges River nearby. But only five or six of them were counted as COVID-19 deaths, he says.

PANDEY: (Non-English language spoken).

FRAYER: "There's a shortage of tests. Nobody's getting tested, so the government's numbers for our district are totally wrong," he says. Across India, funeral pyres light up the night sky. Playgrounds and parking lots have been turned into mass cremation grounds.

ANIKET SIROHI: We are just doing the best we can, but the situation is very grim here.

FRAYER: Dr. Aniket Sirohi has the unenviable job of counting bodies. He's a public health official in the capital, New Delhi, whose job was supposed to be malaria prevention. Every day he visits every crematorium and graveyard in his municipality. Of his 11 staff, five currently have COVID.

SIROHI: You know, it's pretty shaken up, the morale. I have not taken even a single day off.

FRAYER: Last year, at the height of the pandemic's first wave, he was counting 220 COVID deaths a day. Yesterday, he counted more than 700. He passes those numbers up, but what the government ultimately publishes for his region has been at least 20% lower, he says. He attributes it to administrative chaos, people registered in one district but dying in another.

SIROHI: Somehow the numbers are not getting recorded or not shown or getting missed. India had always a poor record of, you know, maintaining this thing. We have a lot of population, so there's a bit of a problem with coordination.

FRAYER: There is another reason why India's coronavirus numbers may be skewed - hubris. In early March, India's health minister declared the pandemic over, but cases were actually creeping up, and some politicians didn't want to ruin the narrative. Dr. A. Velumani runs a nationwide chain of medical labs. He told local media his labs have come under pressure from local politicians to manipulate coronavirus tests and report fewer positive results.

(SOUNDBITE OF ARCHIVED RECORDING)

A VELUMANI: We are told, you shouldn't be doing more than this much. In fact, in a good number of cases, the question asked - why are your laboratories reporting more positive than other local laboratories?

FRAYER: Fewer positives mean fewer deaths attributed to the coronavirus. India's total deaths this week crossed the 200,000 mark, but that's still lower than the toll in the U.S., Brazil and Mexico. There are valid reasons why fewer Indians might die from COVID-19. More than half of the country is under 25. They're more likely to survive the disease. But even considering India's demographics, experts say the real death toll here compared to reported figures...

CHRIS MURRAY: Roughly, we would expect it to be about double.

FRAYER: Chris Murray heads the Institute for Health Metrics and Evaluation at the University of Washington. He says it's not just deaths that are undercounted. India may also be detecting only about 3 or 4% of its daily infections.

MURRAY: We're talking about maybe 5 million infections a day in India right now, which is just a huge number.

FRAYER: And so pretty soon, Murray says, the coronavirus may run out of people to infect here, even in India, a country of 1.4 billion.

MURRAY: We think that infections would be peaking probably next week. And then in our model, we think that deaths will probably peak about the third week of May.

FRAYER: But unfortunately, he says India may see 10,000 or even 12,000 deaths a day by then. Lauren Frayer, NPR News, Mumbai.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.